France's minister of health and social affairs, Marisol Touraine, and the minister of education and research, Geneviève Fioraso, have presented a National Health Strategy to address the main challenges for the healthcare system.
IHS Global Insight perspective
Frances health and education ministers have issued a National Health Strategy which delineates key priorities to improve healthcare performance.
The strategy has identified three main areas of intervention: prioritise prevention and action on determinants of health; improve access to care for patients and organisation of services; and strengthen patients' rights.
The priorities are certainly essential for enhancing quality and equality of the French healthcare system. However, cost-containment measures may impose limitation on the breadth of the strategy implementation.
Marisol Touraine, France's minister of health and social affairs, and the minister of education and research, Geneviève Fioraso, have presented the National Health Strategy (SNS). In particular, the document sets priorities for policy actions aimed at addressing the main challenges for the healthcare system, for example, the ageing population and the spread of chronic diseases, as well as tackling health inequalities. In fact, as it appears from the Ministry of Health (MoH) document, although France diverts substantial resources to healthcare, up to 12% of GDP in 2012, there are still barriers to access to healthcare for sections of the population. Therefore, the MoH has outlined through the SNS three main areas of actions – so-called axes – that are expected to enhance the performance of the French healthcare system. The three axes are:
- prioritise prevention and action on determinants of health;
- improve access to care for patients and organisation of services; and
- strengthen patients' rights.
The full text of the report is available, in French, here.
Three action areas to improve the healthcare system
Prevention represents an essential strategy for ensuring better health outcomes over the long term. Public health priorities will be defined and monitored through a set of indicators that will be developed by the Higher Council for Public Health. Furthermore, prevention will be ensured through health education programmes and training among the younger sections of the population.
Equal access to care will be fostered through the full application of the tiers payant policy that enables poorer patients to be exempted from the payment of advance fees. The exemption will become available to all insured citizens by 2017 for community care services. Furthermore, the government has also announced that healthcare spending will be stabilised after a long period of decline which began in 2004. Finally, healthcare will be organised to be "closer" to patients by, for example, strengthening the role of GPs and community care.
With regard to patients' rights, the SNS envisages the possibility to initiate a class action on health-related issues. Furthermore, information access for patients will be improved. In particular, the government has announced that on 1 October a drug database will be opened to give patients better information on access. Finally, the MoH has underlined that the government aims to preserve the excellence of biomedical research in France and simplify the cumbersome administrative procedures to access to financing.
Outlook and implications
The priorities delineated in the SNS will be followed up with a national law that is scheduled to be presented in 2014 to parliament. However, the forthcoming release of the Financing Social Security Bill (PLFSS) 2014, which defines the funds allocated to the national healthcare system, will already represent a major instrument for the implementation of the financial elements of the strategy for the government.
However, social debt in France is substantial, as highlighted in a recent report from the French Audit Court. The court recommended the implementation of austerity measures to contain the deficit. Therefore, the need for cost contaiment may stand in the way of a full implementation of the SNS. Among other measures, the stabilisation of French healthcare spending may prove to be difficult to be implemented, at least in the short term (see France: 20 September 2013: Audit Court warns of massive public debt levels in France).